The AKT (Applied Knowledge Test) is sometimes seen as the ‘smaller’ of the two exams in GP training. Many however find it a bigger challenge than the CSA given the need for precise knowledge and correct application. It is certainly not to be taken lightly – good planning and smart use of time is essential to get the most out of preparation.

Having sat this exam myself, I remember areas that I struggled with, as well as ideas that I benefitted from.

Below are ten key, but often less discussed tips for this exam – both for preparation, as well as for the day itself.

1) Its in the name. This is not solely a test of knowledge but one of applied knowledge. It is not enough to simply know your stuff. It tests your application of core knowledge in scenarios and situations that you may be faced with in General Practice, whether clinically, evidence-based or managerially. It requires a certain amount of lateral thinking and placing yourself ‘in the situation’ – this is why sometimes more than one answer may seem appropriate. Change your mindset – it is not all about cramming in all you can.

2) Why would you not use the help that is provided to you for free? The RCGP produce two things that many don’t even know about. Firstly, the AKT Content Guide – this is telling you what you need to focus on. Split into the three sections, with the clinical area split down further, it could easily form the basis of your preparation – knowing of what is expected of you is half the battle won. Secondly, the College produces reports of previous exams – where trainees struggled and which areas needed improvement – there’s a fair chance that these will be tested again. Use what is there to help you from the producers of the exam themselves!

3) Start where you don’t want to go. We’re very good at focusing on the areas that we like – if you enjoy and understand cardiology well, chances are that you’ll go there first. Practice the opposite. Decide three topics that you hate and start there. Perhaps genetics? Maybe urology? Usually Statistics. Getting through this first hurdle and realising that you can overcome this prevents the all-too-often, last minute cramming of these topics. Face your fears full on.

4) Targets lead to progress. Don’t revise by walking on a windy path. These come with distractions – the bends lead you to other directions. Make some targets on a straight road and stick to them. ‘Week one I will have covered X; week two I will have covered Y’ and so on. Whatever happens, stick to this – even if it means two full days at the end of the week due to drifting away earlier in the week. Targets ensure completion; wandering leaves you stranded halfway.

5) Don’t only stick to the ‘norm’. People usually follow the same course, as did I for a large chunk of time – same online question banks, repeated again and again. Variety is key. Of course use the revision banks – they are a key focus for revision but don’t neglect the other things out there. There are loads of great AKT books available, each giving you a different spin on question types and areas. You don’t need to buy them – get them from the library. Granted they may have a few out-of-date questions, but 99% does not change. Variety is key to success – discard monotony.

6) Make time pressure work for you. It is always nice to revise and practice questions in the comfort of your own home, in your own time, with the luxury of regular breaks. The exam however is not so nice. Practice recreating time pressure – give yourself 30 minutes to answer X number of questions, one hour to go through X number of topics, three hours to do a full ‘mock’ etc – the unique pressure of a ticking time-bomb makes you think differently. Being a GP constantly reminds you of the need for speedy decisions and good time management – this is definitely tested in the AKT. Don’t experience time pressure for the first time on the day itself.

7) Small words have big impact. Common things are common. We often word-match and decide on answers very quickly. You may see the word ‘iron’ in the question and your eyes flick to the answers – you see ‘haemochromatosis’ and your mind is fixed. The small words in these questions can change the answer in a big way – ‘Usually’, ‘commonly’, ‘most often’ are examples of words that may change the answer to something else – don’t miss them in eagerness to tick the right answer. Small words make up big marks – ignore them at your peril.

8) Things are always easier in picture. Sometimes reading through 4 or 5 lines of text can be a challenge – by the time you get to the end, you’ve forgotten the first two lines. Imagery can help in a huge way. Visualise the patient in front of you. Add layers to the patient as you read the text: ’30 year old female’….’walks with a limp’….’appears to have a swollen ankle’….’you notice a bruise on her shin’ etc. Slowly building up the image is much easier than quickly reading all in one go. Imagination makes you miss less detail – make use of it.

9) Don’t go solo. AKT can be a lonely affair; get home from work, open your book or website, feel alone, isolated and frustrated. Get together with colleagues at least once a week to go over challenging topics, boost each other’s confidence and make plans for the next week. Realising that you are not the only one in this boat, as well as understanding that others also find it a challenge can really help. Push each other, test each other, teach each other.

10) Know you’re going to pass. So often I hear people say ‘I don’t know enough to pass’ or ‘I’ll never cover all of this’. Whilst wishing to pass won’t automatically make it happen, there is definitely something in favour of self-belief. Confidence is a key part of passing any exam – regularly telling yourself that you won’t pass, that you cant pass, but somehow hoping that you will, just makes your preparation that much harder. Regular pep-talks, reminding yourself that you actually know a huge amount and convincing yourself that you will easily pass, will push you that bit harder. Telling yourself that it is impossible, that there is too much and that you will never understand X, Y and Z will only work against you. Focus on the positive end-point and you’ll reach it much more easily.

AKT preparation does need to be taken seriously. It is not just about blindly doing 10,000 questions – understanding what is being assessed and tackling your revision in an organised way makes the process much more effective and much less onerous.

Our AKT Tips YouTube Video covers some of these points in more detail, and our Statistics and Graphs revision videos may also help with your stats revision.

You may also find our ‘big mock AKT course’ of benefit nearer to your exam – designed to highlight your weak points for those all-important last few weeks.

Good Luck!!